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Selective Preservation and Degeneration Within the Prefrontal Cortex in Aging and Alzheimer Disease
David H. Salat, PhD;
Jeffrey A. Kaye, MD;
Jeri S. Janowsky, PhD
Arch Neurol. 2001;58:1403-1408.
Background The prefrontal cortex (PFC) is a heterogeneous cortical structure that
supports higher cognitive functions, including working memory and verbal abilities.
The PFC is vulnerable to neurodegeneration with healthy aging and Alzheimer
disease (AD).
Objective We used volumetric magnetic resonance imaging to determine whether any
region within the PFC is more vulnerable to deterioration with late aging
or AD.
Methods Volumetric analysis of PFC regions was performed on younger healthy
elderly subjects (n = 26; 14 men and 12 women [mean age, 71.7 years] for aging
analysis; 12 men and 14 women [mean age, 71.4 years] for AD analysis), oldest
healthy elderly (OHE) subjects (n = 22 [11 men and 11 women]; mean age, 88.9
years), and patients with AD (n = 22 [12 men and 10 women]; mean age, 69.8
years).
Results The OHE subjects had less PFC white matter than did young healthy elderly
subjects. The orbital region was selectively preserved relative to other PFC
regions in the OHE subjects. Subjects with AD had less total PFC gray matter
than did age-matched healthy subjects and significantly less volume in the
inferior PFC region only.
Conclusions Orbital PFC is selectively preserved in OHE subjects. In contrast, degeneration
within the PFC with AD is most prominent in the inferior PFC region. Thus,
degeneration within the PFC has a regionally distinct pattern in healthy aging
and AD.
From the Departments of Behavioral Neuroscience (Drs Salat and Janowsky)
and Neurology (Drs Kaye and Janowsky) and Portland Veterans Affairs Medical
Center (Dr Kaye), Oregon Health Sciences University, Portland. Dr Salat is
now with the Athinoula A. Martinos Center, Department of Radiology, Massachusetts
General Hospital, Charlestown.
Corresponding author and reprints: David H. Salat, PhD, Athinoula
A. Martinos Center, Department of Radiology, Bldg 149, 13th St, Mail Code
149 (2301), Charlestown, MA 02129-2060 (e-mail:
salat{at}nmr.mgh.harvard.edu).
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